STPs: More engagement, less speed - the inconvenient truth(s)
The recent stories of STP plans being leaked by disgruntled local authorities almost makes me feel sorry for the impossible task facing the band of reluctant STP leaders.
Challenged to go "further faster" in one breath, and then criticised for not engaging widely enough. Truly, a no-win predicament for the STPs and their leaders. The inconvenient truth for the NHS is that the STPs will have to do both things - at the same time.
I absolutely get the need for rapid development of STP proposals. The only way to "grip" difficult and radical reconfiguration is to be bold, brave and brisk. The measured pace of stakeholder engagement can easily slow to the complete inertia induced by uncomfortable choices. Speed matters.
However, at some point you have to make the public case. The STP programme is a radical attempt (the most radical for decades), to confront the challenges that have built up in the system with a mismatch between services, facilities, need and resources. Health professionals get this, but the case has not been made or proved to the amazingly loyal band of NHS lovers that make up local and national electorates. We cannot lose the radicalism but we still have to prove the need for it. Engagement is a must.
Finally very little of the radical change needed can be delivered by one sector only. This is most clearly seen in the community /acute/ primary /social care collaborations. Here the second inconvenient truth is that many of the vital solutions to admission avoidance, delayed discharge etc. are not in the gift or control of the acute sector. Coordinated primary, community and social care resources (linked to acute settings of course) have to have the budget , role and a real voice in these solutions, if they are to be delivered in ways that are truly sustainable as well as transformational.